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P OSTER A BSTRACTS B159 Accuracy of Formulas to Predict Resting Metabolic Rate in Elderly Admitted to a Recuperative Care Unit. D. H. Sullivan, 1,2 K. P. Padala, 1,2 K. K. Garner, 1,2 R. A. Dennis, 1,2 M. Bopp, 1,2 P. R. Padala. 1,2 1. Geriatric Research Education and Clinical Center, VISN16/CAVHS, North Little Rock, AR; 2. Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR. Supported By: VA Health Services and Clinical Science Research and Development programs (HSR&D IIR-04-298 and CSR&D) and a University of Arkansas for Medical Sciences Tobacco Settlement award Background: There is a lack of validation studies of formulas for estimating resting metabolic rate (RMR) in elderly patients in the recuperative phase of illness. Given the importance of such formulas for estimating the nutrient requirements of older medically complex patients, this study was undertaken to explore this issue. Methods: This prospective study included 156 males over 64 years of age admitted to a recuperative care and rehabilitation unit located within a Veterans Affairs hospital Community Living Center. RMR was measured (mRMR) within seven days after admission by indirect calorimetry in the fasted state prior to the subjects’ arising in the morning. Height and weight were measured at the same time. Results: The subjects had a mean age of 79 + 8 years and 85% were white. Although free of metastatic cancer and other terminal conditions, all were deconditioned and most were undernourished and frail. For all 10 published formulas evaluated, estimated RMR (eRMR) was highly correlated with mRMR (r = 0.70 to 0.74, p
P OSTER A BSTRACTS a different strategy than young adults to deal with a walking challenge may potentially inform interventions to improve motor skill in walking. B162 Dual-Stiffness Flooring: Does it Reduce Fracture Rates Among Older Fallers ? F. Knoefel, 1 L. Patrick, 1 J. Taylor, 1 R. Goubran. 2,1 1. EBRI Research Institute, Ottawa, ON, Canada; 2. Engineering and Design, Carleton University, Ottawa, ON, Canada. Supported By: Satech Inc., Chehalis, WA, USA BACKGROUND: Fractures in older adults are associated with significant morbidity and mortality. Falls in this population lead to fractures approximately once every 20 falls. A number of bio-mechanical studies suggest that dual-stiffness flooring (DSF) diminishes the impact of contact with a floor, potentially reducing injuries associated with falls. To our knowledge however, there has never been a controlled study comparing fracture rates on regular flooring to that on DSF. METHODS: Mountain View Manor is a Skilled Nursing Facility in Prescott, Arizona where two resident bedrooms have DSF flooring (SmartCells flooring). Falls and related injuries were tracked during the period of July 1, 2008 to December 31, 2010. Injury rate comparisons, based on Chi-Square analyses, and prediction of room type allocation based on the number of injuries sustained, using Logistic Regression, were conducted. RESULTS: A total of 167 falls were reviewed. Fifty-five percent (55%) of falls resulted in an injury and 26% in a significant injury, defined as abrasion, cut, fracture or two or more injuries. There were 82 falls on the DSF and 85 falls on the regular floor. Patients in the dual-stiffness flooring rooms were significantly younger and took significantly fewer medications; these factors were thus treated as covariates in the analyses. There was a marked tendency for residents falling on DSF to have less bruising and abrasions, while having more redness and cuts. There were two fractures on regular flooring (2.4% fracture rate) and none on the DSF flooring (0% fracture rate). DISCUSSION: A 2.4% fracture rate (as noted on the regular floor) is consistent with numerous incidence reports in the literature; whereas a 0% rate (as noted on Smart- Cells DSF floor) is a clinically significant improvement over prior reported results. Both clinical findings and preliminary statistical trends analysis suggest a positive effect of dual-stiffness flooring. This suggests that DSF may be a practical approach for institutions and consumers to reduce fall-related injuries. In contrast to other solutions, like hip protectors, DSF requires no active client participation. A large scale study to achieve sufficient statistical power to statistically confirm these preliminary findings is warranted. B163 Subcortical Hyperintensities and Outcomes of Targeted Gait Interventions for Mobility Impairment. N. K. Nadkarni, S. Perera, J. Brach, H. Aizenstein, C. Rosano, S. A. Studenski, J. M. Van Swearingen. University of Pittsburgh, Pittsburgh, PA. Supported By: Source of funding: Pittsburgh Claude D. Pepper Older American’s Independence Center grant (P30 AG024827) Background: Gait interventions that incorporate motor-skill acquisition are superior to standard therapy in improving mobility impairment in elderly. Subcortical hyperintensities (SH), commonly seen on brain MRI of older adults, are associated with impairments in gait and executive function. Objective: We examined whether regional SH volumes influence gait outcomes from two types of gait interventions. Methods: We analyzed data from a 12 week randomized trial of community-dwelling older adults with mobility impairment receiving two interventions: progressive strength, balance and endurance training (I) vs goal-directed motor learning, adaptive stepping, pattern walking and dual-tasking (M). A linear model was used to study the relationship between pre- to post-intervention change in outcomes (gait speed, double-support time, step-time, stance time variability) with baseline SH in regions associated with executive function (anterior prefrontal cortex (APC), dorsolateral prefrontal cortex (DLPFC), ventrolateral prefrontal cortex (VLPFC), anterior cingulate (AC), basal ganglia and posterior parietal cortex). Results: Significant interactions emerged between right APC SH and intervention on changes in gait speed (p=0.04), step-time (p=0.001) and double-support time (p=0.01). With respect to steptime change, significant interactions emerged for SH in left APC (p=0.02), right and left DLPFC (p=0.03 and 0.02), right VLPFC (p=0.04) and right AC (p=0.02) with intervention. In the I-group, greater right APC and right AC SH were associated with poorer changes in gait speed (p=0.005 and 0.02), double support time (p=0.002 and 0.001), step-time (p=0.002 and 0.001) and variability in stance-time (p=0.004 and 0.01). In the M-group, there were no significant associations between changes in outcomes and SH in any of the above brain regions. Conclusion: Gait interventions that incorporate motor-skill acquisition and dual-tasking may benefit older adults irrespective of SH severity in brain regions linked to executive function while benefits from impairment-based interventions may depend on SH burden in these regions. B164 Mood and Neurocognitive Measures to Predict Intake and Function in Elderly in a Recuperative Care Unit. P. R. Padala, 1,3 P. Dubbert, 1,3 K. P. Padala, 1,2 K. Garner, 1,2 R. A. Dennis, 1,2 M. Bopp, 1,2 D. H. Sullivan. 1,2 1. Geriatric Research Education and Clinical Center, VISN16/CAVHS, North Little Rock, AR; 2. Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR; 3. Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR. Supported By: VA Health Services and Clinical Science Research and Development programs (HSR&D IIR-04-298 and CSR&D) and a University of Arkansas for Medical Sciences Tobacco Settlement award Background: Among older patients hospitalized for recuperative care and rehabilitation, persistent anorexia and poor functional rehabilitation are associated with high levels of inflammatory markers and other indicators of illness severity at admission. It is not known whether cognitive dysfunction or depression also contribute to the persistent anorexia and poor functional outcomes. Methods: This prospective study included patients over 64 years admitted to a recuperative care and rehabilitation unit in a VA hospital Community Living Center. Each subject’s daily total nutrient intake from all sources was measured using a standardized protocol. Depression was measured by the Geriatric Depression Scale-15 items (GDS), apathy was derived from 3 items on the GDS related to motivation (GDS-apathy), and executive function was measured by verbal fluency, digit span and Florida praxis battery. Correlation analyses were performed between the dependent variables of energy and protein intake with independent variables of mood and neurocognitive measures followed by regression analyses. T-tests were performed on the neurocognitive measures based on if the subjects were apathetic or not. Results: 416 veterans were enrolled. Mean scores at baseline were 3.7 (± 2.7) for GDS, 1.5 (±0.9) for GDS-apathy, 5.9 (±3.7) for Verbal Fluency-F, 7.4 (±2.5) for Digit Span Forward, 4.6 (±2.2) for Digit Span Backwards, 14.6 (±1.4) for Florida Praxis Battery, 83.8 (±35.7) and 59.7 (±23.6)for Average Energy and Protein Intake respectively. Baseline measures of apathy, depression, executive function did not predict either energy or protein intake. However baseline AGS 2012 ANNUAL MEETING S129
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Dear Annual Meeting Attendee: The A
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P APER A BSTRACTS the National Deat
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P APER A BSTRACTS management in col
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P OSTER A BSTRACTS Discussion: Angi
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P OSTER A BSTRACTS ii J Clin Micrbi
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P OSTER A BSTRACTS is on the rise.
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P OSTER A BSTRACTS edema (60%), and
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P OSTER A BSTRACTS incidents (64%)
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P OSTER A BSTRACTS TNF-R1 levels we
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P OSTER A BSTRACTS A75 Geriatrics a
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P OSTER A BSTRACTS NTM infection wa
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P OSTER A BSTRACTS death because
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P OSTER A BSTRACTS A158 Curved Path
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P OSTER A BSTRACTS compared to pati
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P OSTER A BSTRACTS Case: A 78 year-
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P OSTER A BSTRACTS rate was 21.9% f
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P OSTER A BSTRACTS D102 Clinician
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P OSTER A BSTRACTS D114 Fall Reduct
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P OSTER A BSTRACTS D120 Geropsychia
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P OSTER A BSTRACTS In addition to 7
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P OSTER A BSTRACTS D144 The Use of
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A UTHOR I NDEX Azhar, G . . . . . .
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A UTHOR I NDEX Ceimo, J . . . . . .
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A UTHOR I NDEX Dunn, C M . . . . .
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A UTHOR I NDEX Griebling, T L . . .
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A UTHOR I NDEX Johnson, K . . . . .
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A UTHOR I NDEX Levine, M . . . . .
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A UTHOR I NDEX Mulsant, B . . . . .
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A UTHOR I NDEX Pschirer, J P . . .
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A UTHOR I NDEX Sheppard, K D . . .
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A UTHOR I NDEX Ukritchon, S . . . .
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K EYWORD 25-hydroxyvitamin D . . .
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K EYWORD I NDEX Colorectal cancer s
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K EYWORD I NDEX Geriatric curriculu
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K EYWORD I NDEX Medication discrepa
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K EYWORD I NDEX Race . . . . . . .
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